Comparison of Face-to-Face and Mobile Health Messaging Interventions to Enhance Hypertension Knowledge among Cadres in Ngabean dan Trisobo Village, Kendal Regency

Abstract

Hypertension remains the leading risk factor for cardiovascular morbidity and mortality. However, knowledge gaps among the community hinder prevention, early detection, and treatment adherence. Community health cadres play a crucial role as frontline actors in health promotion, screening, and referral. This study aimed to compare the effectiveness of online and face-to-face health education interventions in improving knowledge and attitudes toward hypertension among community health cadres. A pre-experimental one-group pretest–posttest design was conducted from November 2024 to January 2025 in the working area of Boja II Primary Health Care Center, Kendal Regency, Central Java. Thirty-one cadres participated (20 in the online group and 11 in the face-to-face group). The online intervention was delivered via a WhatsApp group over 3 days using 12 educational flyers, while the face-to-face intervention involved a 90-minute session with presentations and discussions. Knowledge and attitudes regarding hypertension were measured using a validated questionnaire (Hypertension Knowledge-Level Scale). Data were analyzed using Wilcoxon signed-rank and Mann–Whitney U tests. In the online group, knowledge scores increased from 11.2 ± 2.1 to 16.5 ± 1.4 and attitude scores from 12.3 ± 1.8 to 16.8 ± 1.5 (p < 0.001). In the face-to-face group, knowledge increased from 11.5 ± 2.3 to 17.2 ± 1.1 (p = 0.003) and attitudes from 12.6 ± 1.7 to 17.5 ± 1.2 (p = 0.004). Posttest comparisons showed significantly higher knowledge (U = 64.5, p = 0.041) and attitude (U = 66.0, p = 0.048) scores in the face-to-face group than in the online group. Both online and face-to-face educational interventions significantly improved knowledge and attitudes toward hypertension among health cadres. However, face-to-face education demonstrated superior effectiveness. Strengthening capacity-building programs for cadres through interactive learning may enhance community-based hypertension prevention and control.